﻿<%@ Page Language="C#" AutoEventWireup="true" MasterPageFile="~/Secure/Workflow.Master" CodeBehind="NeighborAdd.aspx.cs" Inherits="AllenNeighborhood.NeighborAdd" %>

<asp:Content ID="Head" ContentPlaceHolderID="HeadContainer" runat="server" />
<asp:Content ID="Header" ContentPlaceHolderID="HeaderContainer" runat="server" />

<asp:Content ID="Content" ContentPlaceHolderID="ContentContainer" runat="server">
    <img alt="Add Neighbor Banner" src="../Assets/NewNeighborBanner.png" /><br />
    <span style="font-family: Arial, Helvetica, sans-serif; font-size: small; font-weight: normal">
            <br />
    <span style="font-family: Arial, Helvetica, sans-serif; font-size: large; font-weight: bold"><asp:Label ID="MessageText" runat="server" /></span><br />
            <br />
            <table>
            <tr><td>First Name</td><td><asp:TextBox ID="FirstNameBox" runat="server" /></td></tr>
            <tr><td>Last Name</td><td><asp:TextBox ID="LastNameBox" runat="server"/></td></tr>
            <tr><td>House #</td><td><asp:TextBox ID="HouseNumberBox" runat="server"/></td></tr>
            <tr><td>Street</td><td><asp:DropDownList ID="StreetDropDown" runat="server" Width="150"/></td></tr>
            <tr><td>Zip Code</td><td><asp:TextBox ID="ZipCodeBox" runat="server"/></td></tr>
            <tr><td>Phone #</td><td><asp:TextBox ID="PhoneNumberBox" runat="server"/></td></tr>
            <tr><td>Email</td><td><asp:TextBox ID="EmailBox" runat="server"/></td></tr>
            <tr><td>Gender</td><td><asp:DropDownList ID="GenderDropDown" runat="server" Width="150"/></td></tr>
            <tr><td>Race/Ethnicity</td><td><asp:DropDownList ID="EthnicityDropDown" runat="server" Width="150"/></td></tr>
            <tr><td>Age</td><td><asp:TextBox ID="AgeBox" runat="server"/></td></tr>
            <tr><td>Own Home?</td><td><asp:DropDownList ID="OwnHomeDropDown" runat="server" Width="150"/></td></tr>
            <tr><td>Current Coverage</td><td><asp:DropDownList ID="CoverageDropDown" runat="server" Width="150"/></td></tr>
            <tr><td>Newly Enrolled?</td><td><asp:DropDownList ID="NewlyEnrolledDropDown" runat="server" Width="150"></asp:DropDownList></td></tr>
            <tr><td>IHP or Med?</td><td><asp:DropDownList ID="IHPorMEDDropDown" runat="server" Width="150">
                <asp:ListItem></asp:ListItem>
                <asp:ListItem>IHP</asp:ListItem>
                <asp:ListItem>Med</asp:ListItem>
            </asp:DropDownList></td></tr>
            <tr><td>Date Enrolled</td><td><asp:TextBox ID="DateEnrolledBox" runat="server"></asp:TextBox></td></tr>
            <tr><td>Outreach Worker</td><td><asp:TextBox ID="OutreachWorkerBox" runat="server"></asp:TextBox>
            <tr><td>Num of Kids</td><td><asp:TextBox ID="KidsCount" runat="server" /></td></tr>
            <tr><td>Kid&#39;s ages</td><td><asp:TextBox ID="KidsAgesBox" runat="server"></asp:TextBox></td></tr>
            <tr><td>Contact Method</td><td><asp:TextBox ID="BestContactMethod" runat="server" /></td></tr>
            <tr><td colspan="2"><asp:Button ID="NeighborAddButton" runat="server" Text="Add" 
                    onclick="NeighborAddButton_Click" /></td></tr>
    </table>    
    </span>
</asp:Content>

<asp:Content ID="Footer" ContentPlaceHolderID="FooterContainer" runat="server"></asp:Content>